肌萎缩性侧索硬化症的电子T1呼吸力量训练:双盲、随机、多中心、假对照试验半岛投注体育官网10.1212 / WNL.0000000000206830A1 Plowman, Emily K. A1 Gray, Lauren Tabor A1 Chapin, Jennifer A1 Anderson, Amber A1 Vasilopoulos, Terrie A1 Gooch, Clifton A1 Vu, Tuan A1 Wymer, James P. YR 2023 UL http://n.半岛投注体育官网neurology.org/content/early/2023/02/20/WNL.0000000000206830.abstract AB目的:评估12周吸气和呼气呼吸力量训练(RST)对肌萎缩性侧索硬化症(ALS)患者的短期生理和一年功能影响。方法:对45例早期ALS患者进行双盲、随机、假对照试验。参与者被随机分为12周的主动rst(30%负荷，n=23)或假rst(0%负荷，n=22)。进行意向治疗分析。以组状态和前测分数为预测因素，进行前后变化的线性回归。主要指标包括最大呼气和吸气压(MEP, MIP)，次要指标包括咳嗽肺活量测定和肺活量测定。探索性随访结果包括一年的全球和球球衰退(ALS功能评分量表-修订- ALSFRS-R总坡度和球球鳞片下坡度)、口腔吸入状态和无创通气(NIV)时间。结果:RST完成率91%，无RST相关不良事件发生。12周RST计划导致MEP增加(p=0.004)，但MIP没有增加(p=0.33)。平均而言，active-RST后MEP增加了20.8 cmH20 (95% CI: +7.6， +33.9)， sham-RST后MEP下降了1.0 cmH20 (95% CI: -9.1， +7.2)。 Mean MIP increased by 8.9 cmH20 (95% CI: +1.5, +16.3) and 4.8 cmH20 (95% CI: -0.6, +10.2) for the active and sham groups respectively. Secondary Outcomes: RST led to significant increases in cough peak inspiratory flow (p=0.02), however, did not impact cough expiratory flow (p = 0.06) or FVC (p=0.60). Twelve-Month Outcomes: A significant difference in ALSFRS-R Bulbar subscale slope was observed across treatment groups, with a more than two-fold faster rate of bulbar decline in the sham versus active-RST groups observed (-0.29 vs. -0.12 points/month, p=0.02). Total ALSFRS-R slope, feeding status, and time to NIV did not differ across treatment groups (p >0.05).Conclusions: RST was well tolerated and led to improvements in some, but not all, short- and long-term outcomes. RST represents a proactive rehabilitative intervention that could increase physiologic capacity of specific breathing and airway clearance functions during the early stages of ALS. Further work is needed to determine optimal training intensity, resistance load specifications, and potential long-term functional outcomes.

map